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  4. Intervention Effects on Mother-Infant Interaction and Developmental Outcome in Preterm Infants: A Randomization Controlled Trial
 
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Intervention Effects on Mother-Infant Interaction and Developmental Outcome in Preterm Infants: A Randomization Controlled Trial

Date Issued
2011
Date
2011
Author(s)
Leng, Chi-Hon
URI
http://ntur.lib.ntu.edu.tw//handle/246246/250519
Abstract
Chapter 1 The quality of mother-infant interaction in preterm infants may be associated with biological (e.g., perinatal condition) and environmental factors (e.g., parental emotion). Due to biological immaturity and high parental stress, it is crucial to elucidate whether preterm infants differ from term infants in the quality of mother-infant interaction that results in subsequent adverse developmental outcome. The purpose of this paper was therefore to review previous studies regarding parent-infant interaction associated with preterm birth, particularly focusing on the mother-infant interactive behavior in preterm and term infants, the impact of maternal interactive behavior on preterm infants’ development, the optimal model of mother-infant interaction, and the effectiveness of mother-infant interaction education on preterm infants’ developmental outcome. The results showed that negative maternal interactive behaviors, such as more controlling, less sensitivity and less response, more often occurred in preterm infants than in term infants. These negative interactive behaviors were found to associate with later adverse development (e.g. cognitive, language and behavior) in preterm infants. Several intervention studies showed positive effects on early maternal interactive behavior and later child development. In summary, the findings provide important information to help understand the mother-infant interaction associated with preterm birth. Future study needs to investigate what style of mother-infant interaction intervention will best benefit child development. Chapter 2 Objective: To examine the effectiveness of early intervention on mother-infant interaction and developmental outcome in very low birth weight (VLBW) preterm infants; and to investigate whether mother-infant interaction influenced the intervention effect on developmental outcome. Methods: This randomization control trial included 166 VLBW preterm infants (clinic-based intervention program [CBIP]: n=55; home-based intervention program [HBIP]: n=58; usual care program [UCP]: n=53) in the experimental and follow-up period. The CBIP and HBIP commenced in hospitalization and ended at 12 months of corrected age (CA). Mother-infant dyads were examined the quality of interaction in free play at 6, 9 and 12 months CA. Infants were assessed their cognitive, language and motor development at 24 months CA using the Bayley Scales of Infant and Toddler Development-3rd edition. Results: The CBIP group mothers more frequently used high-quality interactive behavior in free play than the UCP group mothers during the experimental period (9 months: difference [95% CI] = 10% [-1% to 21%], p = 0.08; 12 months: difference [95% CI] = 10% [-1% to 22%], p = 0.07). Subsequently, the CBIP group infants showed better cognitive performance (difference [95% CI] = 6.1 [0.9 to 11.4], p = 0.03) and lower incidence of motor delay (odd ratio [95% CI] = 0.2 [0.04 to 1.1], p = 0.06) than the UCP group infants at 24 months CA. Inclusion of the maternal interactive behavior at 12 months CA in the multivariate regression model had significantly attenuated the relation of intervention (CBIP) with cognitive outcome but did not influence intervention effect on motor outcome. In contrast, the maternal interactive behavior and child developmental outcomes did not vary between the HBIP and UCP groups. Conclusions: Early intervention, specifically the CBIP, was beneficial for the mother-infant interaction and cognitive/motor outcome in VLBW preterm infants during the first two years of age. Early maternal interactive behavior might mediate the intervention effect on their cognitive outcome.
Subjects
premature
early intervention
child development
mother-infant interaction
Type
thesis
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